Monday, January 12, 2009

State District Judge Jan Krocker vows to put public safety first and says she's unafraid to mete out tough sentences. But the Republican doesn't take a lock-'em-up-and-throw-away-the-key approach when it comes to handling cases of those with mental illnesses.

"Success in these cases is relative," she said in her chambers last week. "If you have someone who was arrested 25 times for loitering and trespassing in a year and that person gets on medication and arrests drop to five times a year, that's a success."

Krocker, who has been on the bench since 1995, will begin to handle cases of the mentally ill full time in the coming months.

The county is following the lead of scores of other counties across the United States that have created mental health courts with the hope of decreasing the number of mentally ill coming through the criminal justice system.

Such courts can save money by diverting the mentally ill from jail into treatment. Local officials and advocates for the mentally ill warn, however, that one court will have little effect if more treatment services for the mentally ill are not provided in the community.

"A mental health court is a piece of a large puzzle, many of which remain missing. Those include providing housing for this group and case management," said David Buck, president of Healthcare for the Homeless-Houston.

Since 1997, when the nation's first mental health courts were created in Indianapolis, Ind., and Broward County, Fla., more than 150 such courts have begun operating across the country.

Two-fold purpose

Their aim typically has been to provide more humane, effective treatment for the mentally ill and to reduce jail and court costs, said Allison Redlich, a researcher who is studying the effectiveness of mental health courts at Policy Research Associates, which advocates for better treatment of the mentally ill.

Krocker and other state district judges have been pressing for the creation of a mental health court here for several years as the number of mentally ill defendants has swelled. On a given day, nearly 20 percent of the 11,000 inmates at the Harris County Jail receive medications for mental health conditions.

Some mentally ill are arrested so many times, often for minor offenses such as trespassing, that county jail officials have dubbed them "frequent fliers."

With the creation of her court, "I'm hoping some of them will be flying less frequently," Krocker said.

Just as separate courts have been created to address problems such as domestic abuse and drug addiction that weren't always being handled well in regular courts, mental health courts allow judges to gain expertise in handling cases involving schizophrenics and those with other mental disorders, Redlich said.

Better care behind bars

In Harris County and elsewhere, those in need of treatment often receive better mental health care when they are in jail rather than out, Krocker said.

The county and state do not provide enough resources to offer case managers and therapists for all mentally ill inmates when they are released, said Ethel Perry, manager of a local program for mentally ill people on probation. The program -- New Specialized Team of Advocates and Rehabilitation Therapists, or New START -- is run by the county Mental Health and Mental Retardation Authority.

New START receives state funding -- $3 million this year -- to run a program for 300 former inmates. Many were on the verge of having their probation revoked when they entered the program, Perry said.

Krocker envisions working closely with counselors, psychiatrists and the staff of New START.

Perry said praise from a high-ranking official such as a judge can mean a lot to a group of people who often feel like outcasts.

"We are not coddling anybody," said Judge Mark Ellis, who over the past two years has been running one of the two state district courts in Harris County that have been partly devoted to handling cases of mentally ill people on probation. "We are trying to get them to the point that they are on medication and can think for themselves, take some control of their lives, get involved with their kids."

Revocations differ

In 2006 and 2007, the county studied whether mentally ill people on probation who were assigned to the two courts avoided getting into trouble and returning to jail.

Most of these people were in the New START program, and 4 percent had their probation revoked, Ellis said.

During the same period, 30 percent of the mentally ill not in the program had their probation revoked.

Studies of mental health courts in the U.S. have concluded that they reduce recidivism among the mentally ill, the number of violent crimes committed by them and the number of days they spend in jail, Redlich said.

Since becoming better informed about mental illness, Ellis said he no longer thinks the mentally ill invariably should be treated the same as people who have full control of their faculties and recognize right from wrong.

"Mental illness is an illness," he said. "They don't choose to be bipolar or schizophrenic."

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